The Art of Asking: A Guide for the Private Practitioner

Learning from Experience:

When I started my private practice at Mahkota Medical Centre in 1994, there were only 2 obstetricians and gynaecologists, my colleague and me. Since the hospital was new, we told the management that we did not require 2 ultrasound machines. We told them to just buy one machine, and we would share it. So, we placed the machine in a room adjacent to our consultation rooms and shared it. That was not a good idea. Taking turns to use the machine was a waste of our time. Since we were both starting our practice, we spent a lot of time with our patients. The time taken to perform the ultrasound was also long. We used to sit and fret while waiting for our turn to use the machine. I learned the hard way that we should have asked for personal ultrasound machines.

Inspiration from “The Art of Asking”:

Amanda Palmer’s book, “The Art of Asking,” provides valuable insights into the skill of asking. She shares her experiences and insights, emphasizing the importance of vulnerability, connection, and the power of asking for help. I will discuss all the key points of this book and relate it to my experience working in private practice.

1. Asking for help is a strength: Palmer challenges the conventional view that asking for help is a sign of weakness. Instead, she asserts that it is an act of strength and vulnerability. So, embracing the art of asking can be transformative for doctors in private practice who work in an environment of competitiveness. In Private Practice, your colleagues are your competitors. So, asking for help may be seen as a sign of weakness. Palmer highlights the importance of learning from other professions such as law, where collaboration is celebrated. In medicine, particularly in surgical disciplines, seeking assistance is not a sign of incompetence but a strategic move to share responsibilities and risks. However, I must warn that when asking for help don’t take advantage of your colleague who is helping you. 

2. Connecting at a human level: Palmer discusses her experience as a street performer and musician, emphasizing the direct and personal connection she builds with her audience. She encourages artists and creators to connect with their fans on a human level. As doctors, we are taught to think objectively and not be too engaged with our patients. We have to learn the art of being empathetic and objective but yet not involve emotionally with our patients.

3. Trust, Generosity, and Reciprocity: Palmer’s narrative emphasizes the reciprocal nature of trust and generosity. Trust is built through meaningful connections. And by being open to receiving, you create a cycle of giving and receiving. In our line of work as a private practitioner, we have to deal with 4 groups of people: the management of the hospital, our colleagues, the staff, and our patients. Gaining trust with these 4 different groups is important so that we can have a good working environment.

4. Crowdfunding and Direct Support: Palmer successfully used crowdfunding to fund her music projects, demonstrating how direct support from fans can empower artists and creators. I wonder whether crowdfunding is even possible in the medical field. We can definitely lobby for direct support from the management for any new ideas we have. I have had immense support from my management to start many new projects such as setting up an IVF centre, animal workshops, 3D laparoscopy, and recently starting the first HIFU centre in Malaysia.

5. Overcoming fear and shame: The book addresses the fear and shame associated with asking for help. Palmer encourages readers to confront these emotions and recognize the potential for positive outcomes when asking for what you need. I have always felt uncomfortable asking my satisfied patients to write a review on my Google clinic account. I usually let my nurses talk to them about my request. Some oblige to write a review while others don’t but if I don’t ask, I will never get a review.

6. Building a Community: Palmer stresses the importance of building a community around your work. By connecting with others and asking for support, you create a network that can sustain and uplift you. Once a colleague of mine told me that he does not engage with the public on social media. He told me that it is dangerous as any advice given can be taken to court, in case there is a bad outcome. I am not sure whether we need to be paranoid about engaging with our potential patients on social media. I get asked questions on my social media platforms all the time, and I answer them to the best of my ability. With social media, you can now create a community around your practice and engage with the community. This may help grow your practice.

7. Balancing Artistic Integrity and Independence: The book delves into the balance between maintaining artistic integrity and independence while still engaging with and relying on a supportive community. In the medical field, it will be a balance between professionalism and engaging with the community. Some doctors may feel that engaging with the community through social media may be a violation of their privacy while others may consider it educating the public.

8. Learning from other Disciplines: Palmer draws inspiration from various sources, including the DIY (Do it yourself) ethos and the collaborative nature of certain professions such as law. She encourages learning from other disciplines to enhance one’s approach. I am always in awe of the legal professions where different lawyers can work together on a case. Such cooperation rarely exists in Medical Private Practice.

9. The Power of Connection: Ultimately, “The Art of Asking” is a celebration of the profound connections that can be forged through asking, giving, and receiving. It’s a call to embrace vulnerability and recognize the strength in building meaningful relationships. 

So, what advice can I give young doctors going into private practice?

1. Don’t be shy; ask for help.
2. There are 4 groups you can ask for help, namely the hospital management, your colleagues, the staff, and your patients.
3. Ask your hospital management for help in any areas you think you need assistance. Even if the request appears ridiculous, ask anyway. The worst thing that can happen is a NO. Don’t fear the rejection. Keep asking, and one day you will get what you want.
4. To your colleagues, ask for help. Most will be ever willing to help. There will be some who may reject your request, but again you will never know if you don’t try. My only warning is “don’t take advantage of your colleagues.” If you do so, it will be distasteful, and they will not help you the next time.
5. To the staff, ask for help. You will be surprised that your humility will be appreciated by them.
6. To your patients, ask for help as well. Ask them to refer their friends and relatives to you. Ask them to write a good review.
7. One crucial piece of advice is to recognize the bargaining power you possess when a hospital seeks your services. Use this leverage wisely by articulating your needs upfront. Request everything necessary for delivering optimal patient care and honing your professional skills. Once you’ve committed to a practice, securing additional resources becomes more challenging.